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BACKGROUND: Polycystic ovary syndrome (PCOS) is a common chronic endocrine disorder in women with complex and poorly understood etiologies. The present study aimed to describe the clinical features of PCOS in a sample of Syrian women as well as the risk factors, associated comorbid diseases, and patterns and efficacy of treatment. METHODS: The present study is cross-sectional observational study conducted on a sample of Syrian women diagnosed with PCOS, using self-administered questionnaire during the period between December 25, 2023 and January 18, 2024. Overall, 1666 women with PCOS were recruited through online platforms. RESULTS: Higher frequency of PCOS was observed in young women aged 15-25 years (63.1%) and in single ladies (76.5%). The main chief complaints experienced by patients with PCOS were hirsutism (71.25%), irregular menstrual cycle (70.95%), depressed mood (53.9%), acne (49.52%), abdominal obesity (43.88%), alopecia (38.12%), and weight gain (34.57%). The most common risk factors observed in patients with PCOS were lack of physical exercise (76.4%), unhealthy food habits (51.6%), family history (38.5%), and history of taking anabolic steroids (17.2%). Comorbid diseases were found in 11.5% of PCOS patients. These diseases were hypothyroidism (5.7%), hypertension (3.06%), dyslipidemia (1.68%), heart diseases (1.56%), and diabetes mellitus (0.78%). Most patients were treated with oral contraceptive pills (82.11%) or metformin (64.83%). The efficacy of treatment was observed as complete cure in 430 patients (25.8%) and partial response alleviating symptoms in 819 patients (49.2%), while and no benefit was found in 417 patients (25%). CONCLUSIONS: PCOS is associated with widespread dermatological and metabolic aberrations that pose psychological burden on women and increase their risk for having comorbid diseases. Most patients with PCOS do not receive adequate therapy. Understanding the risk factors and clinical features for each patient is essential to choose the proper treatment.

Asunto(s)

Síndrome del Ovario Poliquístico , Humanos , Femenino , Síndrome del Ovario Poliquístico/complicaciones , Síndrome del Ovario Poliquístico/epidemiología , Adulto , Estudios Transversales , Adulto Joven , Adolescente , Siria/epidemiología , Factores de Riesgo , Resultado del Tratamiento , Comorbilidad , Hirsutismo/epidemiología , Encuestas y Cuestionarios

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Chronic diseases and pain exacerbate depressive symptom in Syria. Limited research on hospital-induced depressive symptom among Syrian patients with chronic diseases warrants further study. A cross-sectional study in four Damascus hospitals revealed high rates of pain and depressive symptom. This study aims to investigate the prevalence and severity of chronic pain and hospital-induced depressive symptom in Syrian patients, as well as the relationship between pain, depressive symptom, and medication behavior. This study analyzes the impact of pain, hospitalization, and medication on patients with chronic diseases. The four Damascus hospitals included 453 patients from various departments. Data were collected through structured interviews and internationally recognized scales such as the PSEQ, HADS, and MMAS. These findings offer insights into pain management and psychological well-being, with implications for patient care and support strategies. The study involved 453 patients with chronic diseases, with gender distribution showing 46.6% females and 53.4% males. The age range was from 7 to 87 years, with an average of 46.87 years. Chi-square tests revealed a significant connection between gender and HADS-A scores, where 48.3% of females had abnormalities (χ2 (1, N = 453) = 7.125, p = 0.028). Marital status was significantly associated with anxiety and depressive symptom levels, particularly among widowed and divorced patients. Employment status, education, and comorbidity were linked to abnormal HADS-A scores, while education level showed a positive correlation with HADS-D scores. ANOVA tests showed significant differences in MMAS scores across income groups (F (3, 449) = 3.167, p = 0.024), with a notable difference between low-income and lower-middle-income groups (mean difference = 0.389, p = 0.031. Chronic pain and HID are prevalent among Syrian patients with chronic diseases and influenced by socio-demographic factors. Personalized interventions are needed to address psychological symptoms and medication behavior.

Asunto(s)

Depresión , Hospitalización , Humanos , Masculino , Femenino , Persona de Mediana Edad , Siria/epidemiología , Adulto , Depresión/epidemiología , Anciano , Estudios Transversales , Adolescente , Enfermedad Crónica , Adulto Joven , Anciano de 80 o más Años , Dolor Crónico/tratamiento farmacológico , Dolor Crónico/epidemiología , Dolor Crónico/psicología , Niño , Prevalencia

RESUMEN

BACKGROUND: This study was conducted to examine the prevalence of malnutrition in Syrian immigrant children living in Turkey. METHODS: The study was carried out in the city of Mardin, which is one of the cities with a high Syrian immigrant population in Turkey. Height, body weight and BMI values were recorded to determine the malnutrition status of the children. Z-scores of children were calculated using the malnutrition assessment WHOAntro program. RESULTS: The data show that 30.5% of Syrian children between the ages of 0 and 6 months are male, making up 55.8% of the total, and that 55.3% do not follow a regular breakfast schedule. The percentages of body weight for height, height for age, and BMI for age of Syrian children with a score between - 2 and + 2 SD Number were (89.3%), (74.3%), and (79.3%), respectively. Girls are more likely than boys to experience stunting and low body weight in the context of Syrian children (Stunting OR: 0.855(0.761-1.403), Underweight OR: 0.705(0.609-1,208)). Additionally, there is a link between levels of stunting and underweight and elements like the mother's educational level and the family's income. Contrary to the situation of adequate nutrition, it was discovered that the likelihood of stunting and low body weight in children increased by 0.809 and 1.039 times, respectively, when access to an adequate food supply was not available within the family (p < 0.05). CONCLUSION: s According to the results of the study, gender, family income, mother's education level and access to food affected the severity of malnutrition in children. Migration is an imporatnt factor affecting children's health. In this study malnutrition was found high im immigrant children. Programs should be developed to monitor the growth and development of disadvantaged children and to support their nutrition.

Asunto(s)

Factores Socioeconómicos , Humanos , Masculino , Femenino , Estudios Transversales , Siria/etnología , Siria/epidemiología , Turquía/epidemiología , Preescolar , Lactante , Niño , Recién Nacido , Desnutrición/epidemiología , Prevalencia , Trastornos de la Nutrición del Niño/epidemiología , Emigrantes e Inmigrantes/estadística & datos numéricos

RESUMEN

BACKGROUND: Low back pain (LBP) majorly contributes to activity limitations and work absences worldwide. Therefore, a comprehensive knowledge of the risk factors linked to non-specific low back pain (NSLBP) can enable early and timely interventions to achieve long-term improvements. Current study aimed to assess the risk factors associated with the severity of NSLBP patients in Syria. METHODS: This study used a cross-sectional design and a self-assessment questionnaire to collect data on NSLBP, as well as personal and physical factors, across four provinces in Syria (Damascus, Aleppo, Homs, and Latakia) from November 2021 to September 2022. The assessments incorporated the Short Form 36-Item Health Survey (SF-36), the Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI). Then we examined the relationship between the severity of NSLBP and these potential risk factors. Descriptive statistics were employed to summarize the demographic characteristics of the participants. Additionally, multiple logistic regression analysis was performed to evaluate the risk factors for non-specific low back pain. RESULTS: The study included a total of 875 patients with NSLBP. The results indicated that patients with primary school education, a high body mass index (BMI), prolonged driving and sitting durations, smoking habits, and recurrent low back pain had higher VAS and ODI scores, as well as lower SF-36 scores (p < 0.01). Additionally, workers and drivers had higher VAS and ODI scores and lower SF-36 scores compared to waiters and patients who lifted objects heavier than 10 kg for more than a quarter of their work time for over 10 years (p < 0.01). The multiple logistic regression analysis revealed that lower education levels, low back pain lasting 1-7 days, chronic low back pain in the past year, smoking, driving for prolonged time, and higher BMI were associated with more severe VAS scores. CONCLUSION: The severity of NSLBP is related to lower education levels, poor living conditions, strenuous physical labor, inactive lifestyle, and driving for a long time. Additionally, patients with recurrent NSLBP experience more intense pain. To manage these issues, potential interventions could include reducing obesity rates, limiting the duration of hard physical work, limiting driving duration and reducing sedentary behaviors and smoking. These measures may help alleviate the overall burden of NSLBP.

Asunto(s)

Dolor de la Región Lumbar , Dimensión del Dolor , Índice de Severidad de la Enfermedad , Humanos , Siria/epidemiología , Dolor de la Región Lumbar/epidemiología , Dolor de la Región Lumbar/diagnóstico , Masculino , Femenino , Factores de Riesgo , Adulto , Estudios Transversales , Persona de Mediana Edad , Evaluación de la Discapacidad , Fumar/epidemiología , Índice de Masa Corporal , Conducción de Automóvil , Escolaridad , Adulto Joven , Encuestas y Cuestionarios , Conducta Sedentaria

RESUMEN

STUDY OBJECTIVE: This study aims to assess the prevalence of both classic and non-classic pain sites in patients with ischemic heart disease, emphasizing the importance of recognizing and not disregarding non-classic symptoms. METHODS: This cross-sectional study included 100 patients diagnosed with coronary artery disease (CAD) who were admitted to two major hospitals in Syria. classic pain was identified as pain located in the precordial area, with or without radiation to the neck, jaw, left shoulder or arm. Patients' demographics and previous medical history were documented to investigate any potential associations with non-classic pain. RESULTS: 62% of the patients experienced non-classic pain, while 12% had no precordial pain. For those without precordial pain, the most common pain site was the left chest (66.7%). Non-classic pain was significantly associated with smoking, with 72.2% of smokers experiencing non-classic pain compared to 35.7% non-smokers (p = 0.001). Additionally, patients with previous heart disease were more likely to have non-classic pain (71.7%), compared with patients with no history of heart disease (51.1%) (p = 0.03). Other factors such as age, sex, and diabetes were not statistically significant. CONCLUSION: Non-classic pain is common, affecting 62% of individuals, primarily in the right shoulder, right arm, and back. This type of pain could be associated with smoking and prior heart disease. Misdiagnosing coronary artery disease can have serious consequences, as patients with non-classic symptoms may miss important pre-hospital procedures like ECG.

Asunto(s)

Enfermedad de la Arteria Coronaria , Humanos , Estudios Transversales , Masculino , Femenino , Persona de Mediana Edad , Prevalencia , Enfermedad de la Arteria Coronaria/epidemiología , Enfermedad de la Arteria Coronaria/diagnóstico , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Anciano , Siria/epidemiología , Dolor en el Pecho/epidemiología , Dolor en el Pecho/etiología , Dolor en el Pecho/diagnóstico , Factores de Riesgo , Fumar/epidemiología , Fumar/efectos adversos , Dimensión del Dolor , Adulto

RESUMEN

Stroke is a global public health concern, contributing to high rates of morbidity and mortality. In Syria, the current conflict and associated challenges have had a profound impact on healthcare infrastructure, including education and awareness programs related to stroke. An essential aspect of preventing stroke is the awareness of individuals. The study aimed to investigate factors associated with knowledge and awareness of stroke among Syrian people. A cross-sectional national representative study was conducted in Syria. The questionnaire was created on Google form and disseminated as a link through online platform social media like Facebook, WhatsApp, and Twitter. The population of the study was divided using proportionate random sampling into the 14 governorates. A random sample was selected from each area. The STROBE reporting guideline for cross-sectional studies was followed. Logistic regression analysis was performed to identify the factors associated with poor knowledge of stroke. A total of 1013 Syrian adults participated in the study. With more than half of them were females (53.5%) and employed (55.6%). Significant associations were found between ability to identify at least one correct risk factor and employability status (p = 0.029), single group (p = 0.036) and smokers (p < 0.001). In addition, significant associations were found between identifying at least one correct stroke symptom and smokers (p < 0.001) and no-obese people (p = 0.048). Furthermore, younger age group (below 30 years) were significantly able to list at least one correct stroke consequence compared to the older age groups (p = 0.025). Moreover, a significantly higher number of smokers compared to non-smokers correctly identified at least one stroke consequence (p = 0.019). The study revealed that there is a relatively weak understanding of the preventable nature of stroke among Syrian population. The overall awareness is still inadequate and varies depending on lifestyle factors and employment status.

Asunto(s)

Conocimientos, Actitudes y Práctica en Salud , Accidente Cerebrovascular , Humanos , Siria/epidemiología , Femenino , Masculino , Adulto , Persona de Mediana Edad , Estudios Transversales , Accidente Cerebrovascular/epidemiología , Encuestas y Cuestionarios , Factores de Riesgo , Adulto Joven , Adolescente , Anciano

RESUMEN

INTRODUCTION: Since the Syrian Civil War began in 2011, the official number of refugees under temporary protection in Turkiye is reported to be 3,522,036 in 2023. Most of the Syrians living outside the refugee camps have worse conditions in terms of access to healthcare centers and social opportunities, compared to those living in camps. The Sanliurfa province hosts the third highest number of Syrians (370,291) in Turkiye. There are no data about the seroprevalence of Toxoplasma gondii (T. gondii), rubella (rub), or cytomegalovirus (CMV) among Syrian refugees in Sanliurfa. We aimed to investigate the seroprevalence of T. gondii, rub, and CMV infections among female Syrian refugees of reproductive age (15-49 years) living in Sanliurfa province. METHODOLOGY: A cross-sectional study was conducted in different districts of Sanliurfa. A total of 460 households were selected using the probability sampling method. One married female Syrian refugee aged between 15 and 49 years, was chosen in each household, leading to a sample size of 410 female Syrian refugees. The seropositivity of T. gondii, CMV, and rub IgM and IgG in blood samples were analyzed using enzyme immunoassays (Abbott Architect, Illinois, USA). RESULTS: The seropositivity rates of T. gondii, CMV, and rubella IgM and IgG were 4.4% and 59.8%; 3.9%; and 99%; and 1.9%, and 99.5%, respectively. CONCLUSIONS: A screening program should be implemented for T. gondii, CMV, and rub infections for Syrian refugees. Seronegative women should be vaccinated against rub and educated about the transmission and preventive routes of toxoplasmosis and CMV infection.

Asunto(s)

Infecciones por Citomegalovirus , Refugiados , Rubéola (Sarampión Alemán) , Toxoplasmosis , Humanos , Femenino , Refugiados/estadística & datos numéricos , Adulto , Estudios Seroepidemiológicos , Toxoplasmosis/epidemiología , Adolescente , Adulto Joven , Rubéola (Sarampión Alemán)/epidemiología , Siria/epidemiología , Siria/etnología , Persona de Mediana Edad , Estudios Transversales , Infecciones por Citomegalovirus/epidemiología , Turquía/epidemiología , Toxoplasma/inmunología , Anticuerpos Antivirales/sangre , Citomegalovirus/inmunología , Citomegalovirus/aislamiento & purificación , Inmunoglobulina M/sangre

RESUMEN

The prevalence of overactive bladder (OAB) is known to be higher in patients with type 2 diabetes (T2DM). However, few studies have examined specific risk factors contributing to its progression among diabetes mellitus (DM) patients, so this study aimed to investigate the risk factors specific to diabetes mellitus that influence overactive bladder in the Syrian population. This cross-sectional study was conducted at four endocrinology centers in four Syrian provinces: Damascus, Aleppo, Homs, Hama, and Latakia. The study was comprised of patients who had been diagnosed with both T2DM and OAB and had visited these centers from February 2020 to January 2023. The Arabic version of the Overactive Bladder Symptom Score (OABSS) scale was used to categorize the participants based on the severity score into two groups: the mild OAB group and the moderate-severe OAB group. A logistic analysis was conducted to assess the risk factors associated with the OAB among patients with diabetes. Among the 153 patients diagnosed with both DM and OAB, significant distinctions were found between the two groups concerning the severity of overactive bladder, age, duration of diabetes, symptomatic diabetic peripheral neuropathy (DPN), and ankle reflex (P < 0.05). Furthermore, a multivariate analysis revealed that age (OR 1.48, 95% CI 0.89-2.19), duration of diabetes (OR 1.94, 95% CI 0.53-2.23), and symptomatic DPN (OR 2.74, 95% CI 1.39-4.13) independently acted as risk factors for the advancement of OAB. The severity of OAB in Syrian patients with diabetes is closely associated with the severity of DM. Factors such as age, duration of diabetes, and symptomatic DPN are independent predictors of the severity of OAB. Patients who experience symptomatic DPN are at an increased risk of developing OAB.

Asunto(s)

Diabetes Mellitus Tipo 2 , Índice de Severidad de la Enfermedad , Vejiga Urinaria Hiperactiva , Humanos , Vejiga Urinaria Hiperactiva/epidemiología , Vejiga Urinaria Hiperactiva/etiología , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/epidemiología , Siria/epidemiología , Femenino , Masculino , Persona de Mediana Edad , Factores de Riesgo , Estudios Transversales , Anciano , Adulto , Prevalencia , Neuropatías Diabéticas/epidemiología , Neuropatías Diabéticas/etiología

RESUMEN

PURPOSE: On February 6, 2023, two earthquakes of magnitude 7.7 and 7.6 occurred consecutively in Turkey and Syria. This study aimed to investigate the predisposing factors for wound infection (WI) and the microbiological characteristics of wounds after earthquake-related injuries. METHODS: This descriptive study evaluated pediatric patients' frequency of WI, and the clinical and laboratory parameters associated with the development of WI were investigated. RESULTS: The study included 180 patients (91 female). The mean age of the patients was 123.9 ± 64.9 months and 81.7% (n = 147) of them had been trapped under rubble. Antibiotic treatment to prevent WI had been administered to 58.8% (n = 106) of all patients. WI was observed in 12.2% (n = 22) of the cases. In patients who developed WI, the incidence of exposure to a collapse, crush syndrome, compartment syndrome, multiple extremity injury, fasciotomy, amputation, peripheral nerve injury, thoracic compression, blood product use, intubation, and the use of central venous catheters, urinary catheters, and thoracic tubes were more frequent (p < 0.05). The need for blood product transfusion was associated with the development of WI (OR = 9.878 [95% CI: 2.504-38.960], p = 0.001). The negative predictive values of not developing WI at values of white blood cell count of < 11,630/mm3, creatine kinase < 810 U/L, potassium < 4.1 mEq/L, ALT < 29 U/L, AST < 32 U/L, and CRP < 45.8 mg/L were 93.7%, 96.8%, 90.8%, 93.3%, 100%, and 93.5%, respectively. Gram-negative pathogens (81%) were detected most frequently in cases of WI. Seventy-five percent of patients were multidrug- and extensively drug-resistant. CONCLUSION: This study leans empirical approach of our disaster circumstances. In cases with risk factors predisposing to the development of WI, it may be rational to start broad-spectrum antibiotics while considering the causative microorganisms and resistance profile to prevent morbidity.

Asunto(s)

Terremotos , Infección de Heridas , Humanos , Femenino , Masculino , Niño , Infección de Heridas/epidemiología , Infección de Heridas/microbiología , Turquía/epidemiología , Preescolar , Adolescente , Siria/epidemiología , Factores de Riesgo , Antibacterianos/uso terapéutico , Incidencia , Lactante

RESUMEN

It is aimed to examine the frequency of COVID-19 disease, the rates of COVID-19 vaccination and the vaccine effectiveness (VE) among Syrian refugees. It is a retrospective cohort study. Syrian refugees aged 18 years and above registered to a family health center in Sultanbeyli district in Istanbul were included. Vaccine effectiveness were calculated for both Pfizer BioN-Tech and CoronaVac (Sinovac) vaccines. The data of 2586 Syrian people was evaluated in the study. The median age of the participants was 34.0 years (min:18.0; max: 90.0). Of the participants 58.4% (n = 1510) were female, 41.6% (n = 1076) were male. In our study of the refugees 15.7% had history of COVID-19 infection. Refugees having full vaccination with Biontech and Sinovac have a significantly lower COVID-19 infection rate than those without vaccination (HR = 8.687; p < 0.001). Adjusted VE for Biontech, Sinovac, and both were 89.2% (95.0% CI:83.3-93.1), 81.2% (95.0% CI:48.72-93.1) and 88.5% (95.0% CI:82.7-92.3), respectively. The results of the study highlight the importance of vaccinations against COVID-19 pandemic, since both vaccines were highly protective in refugees.

Asunto(s)

Vacunas contra la COVID-19 , COVID-19 , Refugiados , SARS-CoV-2 , Vacunación , Humanos , Refugiados/estadística & datos numéricos , COVID-19/prevención & control , COVID-19/epidemiología , Siria/epidemiología , Siria/etnología , Masculino , Femenino , Adulto , Vacunas contra la COVID-19/administración & dosificación , Vacunas contra la COVID-19/inmunología , Estudios Retrospectivos , Persona de Mediana Edad , Adolescente , Adulto Joven , Anciano , SARS-CoV-2/inmunología , Vacunación/estadística & datos numéricos , Anciano de 80 o más Años , Eficacia de las Vacunas

RESUMEN

Introduction: Currently, over two million war refugees live in Germany. Exposure to war and flight is associated with a high burden of diseases, not limited to mental disorders and infections. We aimed to analyze diabetes treatment and outcomes of pediatric refugees and migrants from Ukraine and Syria/Afghanistan with type 1 diabetes (T1D) in German-speaking countries. Materials and methods: We included patients with T1D documented between January 2013 and June 2023 in the German/Austrian/Luxembourgian/Swiss DPV registry, aged < 20 years, born in Ukraine [U], in Syria or Afghanistan [S/A], or without migration background [C]. Using logistic, linear, and negative binomial regression models, we compared diabetes technology use, BMI-SDS, HbA1c values, as well as severe hypoglycemia and DKA rates between groups in the first year of treatment in the host country. Results were adjusted for sex, age, diabetes duration, and time spent in the host country. Results: Among all patients with T1D aged < 20 years, 615 were born in Ukraine [U], 624 in Syria or Afghanistan [S/A], and 28,106 had no migration background [C]. Compared to the two other groups, patients from Syria or Afghanistan had a higher adjusted BMI-SDS (0.34 [95%-CI: 0.21-0.48] [S/A] vs. 0.13 [- 0.02-0.27] [U] and 0.20 [0.19-0.21] [C]; all p<0.001), a lower use of CGM or AID system (57.6% and 4.6%, respectively [S/A] vs. 83.7% and 7.8% [U], and 87.7% and 21.8% [C], all p<0.05) and a higher rate of severe hypoglycemia (15.3/100 PY [S/A] vs. 7.6/100 PY [C], and vs. 4.8/100 PY [U], all p<0.05). Compared to the two other groups, patients from Ukraine had a lower adjusted HbA1c (6.96% [95%-CI: 6.77-7.14] [U] vs. 7.49% [7.32-7.66] [S/A] and 7.37% [7.36-7.39] [C], all p<0.001). Discussion: In their first treatment year in the host country, young Syrian or Afghan refugees had higher BMI-SDS, lower use of diabetes technology, higher HbA1c, and a higher rate of severe hypoglycemia compared to young Ukrainian refugees. Diabetologists should be aware of the different cultural and socioeconomic backgrounds of refugees to adapt diabetes treatment and education to specific needs.

Asunto(s)

Diabetes Mellitus Tipo 1 , Refugiados , Migrantes , Humanos , Siria/etnología , Siria/epidemiología , Refugiados/estadística & datos numéricos , Ucrania/epidemiología , Femenino , Masculino , Diabetes Mellitus Tipo 1/terapia , Diabetes Mellitus Tipo 1/epidemiología , Afganistán/epidemiología , Niño , Adolescente , Migrantes/estadística & datos numéricos , Alemania/epidemiología , Preescolar , Adulto Joven , Hemoglobina Glucada/análisis , Sistema de Registros , Lactante , Hipoglucemiantes/uso terapéutico

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Depression and anxiety often coexist with rheumatoid arthritis (RA) and affect the course of the disease. These mental health conditions can be overlooked or underdiagnosed in people with RA. There is conflicting evidence in previous studies regarding this topic, indicating that further research is necessary to provide a thorough understanding of the relationship between anxiety, depression, and RA. This study aims to determine the factors correlated with depression and anxiety symptoms in RA patients by evaluating disease activity at the same time. This cross-sectional study was conducted at four outpatient rehabilitation centers in four Syrian provinces: Damascus, Homs, Hama, and Latakia. The study included RA patients who attended the RA department of rehabilitation centers from January 1 to June 31, 2023. RA patients who presented at a rheumatology clinic were selected consecutively. RA patients were included in the study in accordance with the ACR/EULAR classification criteria, disease activity was assessed by disease activity score based on the 28-joint count (DAS28), and patients with DAS28 > 2.6 were considered to have active RA. The demographic data, as well as disease duration, educational status, Disease Activity Score with 28-joint counts (DAS28), health assessment questionnaire (HAQ) score, and the hospital anxiety and depression scale (HADS), were the parameters used in the analysis. Two hundred and twelve patients (female, 75%) with a mean age of 49.3 ± 13.1 years and a mean disease duration of 8.3 ± 6.9 years were studied. Depression was diagnosed in 79 (37.3%) patients and anxiety in 36 (16.9%) patients. Patients with depression and/or anxiety had higher HAQ and DAS28 scores compared to other RA patients. Blue-collar workers exhibited a higher prevalence of anxiety, whereas females, housewives, and individuals with lower educational attainment demonstrated a higher prevalence of depression. The current study found high rates of anxiety and depression in RA patients, highlighting the significant burden of these mental health conditions compared to the general population. It is essential for healthcare providers not to overlook the importance of psychiatric evaluations, mental health assessments, and physical examinations of RA patients.

Asunto(s)

Ansiedad , Artritis Reumatoide , Depresión , Humanos , Artritis Reumatoide/complicaciones , Artritis Reumatoide/psicología , Artritis Reumatoide/epidemiología , Femenino , Masculino , Siria/epidemiología , Estudios Transversales , Persona de Mediana Edad , Ansiedad/epidemiología , Depresión/epidemiología , Adulto , Anciano , Encuestas y Cuestionarios

RESUMEN

OBJECTIVES: The aim of this study is a descriptive presentation of cases of acute watery diarrhoea (AWD) that were presented to Aleppo University Hospital (AUH) during the recent cholera outbreak in Syria. DESIGN: Prospective, observational, cohort study. SETTING AND PARTICIPANTS: A total of 1061 patients with AWD were admitted to AUH during the timeframe of 20 September 2022 to 20 October 2022. The data collection was done through a structured questionnaire. This includes comprehensive clinical observation, laboratory analyses, therapeutic interventions and holistic case evaluations. RESULTS: The analysis has revealed notable insights: a predominant proportion of patients (58.6%) were residents from urban areas and 40.3% were residents from rural areas. Intriguingly, a diverse range of potential infection sources emerged from patient data within our hospital, including uncontrolled well water, vegetables and faecal-oral transmission through contaminated street/fast food. At discharge, most patients were in good health (79.7%), followed by moderate health (17.6%) and poor health (2.3%), with a minimal percentage dying before discharge (0.4%). The most common complications reported at admission and during hospitalisation included electrolyte imbalance (28.2%), followed by severe dehydration (16.3%). In the follow-up period, the majority of patients exhibited good health (81.0%). Older patients (>60 years) had poorer outcomes, with 8.4% having poor health and 4.2% death rate. CONCLUSIONS: The study found results consistent with previous AWD outbreaks in developing countries like Yemen, Nigeria and Lebanon. Preventative measures like improving water sanitation and hygiene practices are essential to prevent future outbreaks and ease the strain on healthcare systems. Therefore, future studies must investigate the risk factors that increase the spread and the severity of the disease and investigate the best management method.

Asunto(s)

Cólera , Diarrea , Brotes de Enfermedades , Humanos , Cólera/epidemiología , Cólera/terapia , Masculino , Femenino , Adulto , Estudios Prospectivos , Siria/epidemiología , Adolescente , Diarrea/epidemiología , Diarrea/microbiología , Adulto Joven , Persona de Mediana Edad , Niño , Preescolar , Lactante , Enfermedad Aguda , Anciano

RESUMEN

People with ankylosing spondylitis (AS) are vulnerable group to experience mood disorders. It is crucial to identify factors that contribute to depression and anxiety in order to improve outcomes. This study seeks to determine the rates of depression and anxiety in Syrian AS patients, as well as identify potential predictors for these conditions. This cross-sectional study was conducted using convenience sampling at the Biological Treatment Unit of the Rheumatology Department of the Damascus Hospital. Data were collected from face-to-face interviews with patients using validated structural questionnaire. A multivariate linear regression model was used to investigate potential predictive factors of depressive and anxiety symptoms. Of the 103 patients, 49.5% showed clinically significant depressive symptoms, and 36.9 % showed clinically significant anxiety symptoms. Multivariate linear regression indicated that depressive and anxiety symptoms were predicted by job layoff, hip pain, positive history of mental distress, poor quality of life, severe fatigue, and high frequency of sleep disturbance with relatively high explanatory powers. depressive and anxiety symptoms were predicted by disease activity scores but with low explanatory power. This study demonstrated high levels of that depressive and anxiety symptoms among Syrian patients with AS undergoing biological treatment. Poor quality of life, severe fatigue, and high-frequency sleep disturbances are major predictive factors for depressive and anxiety symptoms. Screening for depression and anxiety holds significant importance in the comprehensive management of ankylosing spondylitis even in the context of concurrent biological treatment administration.

Asunto(s)

Trastornos del Sueño-Vigilia , Espondilitis Anquilosante , Humanos , Espondilitis Anquilosante/complicaciones , Espondilitis Anquilosante/tratamiento farmacológico , Espondilitis Anquilosante/diagnóstico , Estudios Transversales , Calidad de Vida , Siria/epidemiología , Ansiedad/etiología , Ansiedad/complicaciones , Fatiga/complicaciones , Trastornos del Sueño-Vigilia/complicaciones , Depresión/etiología , Depresión/complicaciones

Asunto(s)

Neoplasias Pulmonares , Humanos , Siria/epidemiología

RESUMEN

BACKGROUND: Idiopathic nephrotic syndrome (INS) is the most common glomerular disease in children. We performed this study to report histopathological findings, the correlation between clinical and histopathological features, and the response to steroids and other immunosuppressive drugs and outcomes in Syrian children with INS. METHODS: A single-center retrospective observational cohort study was conducted at Children's University Hospital in Damascus, and included all patients aged 1-14 years, admitted from January 2013 to December 2022, with INS and who underwent kidney biopsy. RESULTS: The study included 109 patients, with a male/female ratio of 1.13:1, and a median age of 5 years with interquartile range (2.8-10). The main indication of kidney biopsy was steroid-resistant nephrotic syndrome (SRNS) (57.8%). The main histopathological patterns were minimal change disease (MCD) (45%) and focal segmental glomerulosclerosis (FSGS) (37.6%). FSGS was the most common histopathological pattern in SRNS (44.3%). In SRNS, we used calcineurin inhibitors to induce remission. Tacrolimus was used in 49 patients with response rate (complete remission of proteinuria) of 69.4% and cyclosporine in 20 patients with response rate of 50%. In steroid-dependent nephrotic syndrome (SDNS), we used mycophenolate mofetil (MMF) and cyclophosphamide to prevent relapses; MMF was used in 9 patients with response rate (maintaining sustained remission) of 89% and cyclophosphamide in 3 patients with response rate of 66.7%. Rituximab was used in four patients with FSGS, two SRNS patients and two SDNS patients, with sustained remission rate of 100%. Fifteen patients (13.7%) progressed to chronic kidney disease stage 5. Of them, 7 patients had FSGS and 8 patients had focal and global glomerulosclerosis;14 of them were steroid-resistant and one patient was steroid-dependent with persistent relapses. The most common outcome was sustained remission (47%) in MCD and frequent relapses (31.7%) in FSGS. CONCLUSIONS: FSGS was the most common histopathological pattern in idiopathic SRNS and had the worst prognosis. Calcineurin inhibitors could be an effective therapy to induce complete remission in SRNS. Rituximab may be an effective treatment to achieve sustained remission in SDNS and frequently relapsing NS and may have a potential role in SRNS with further studies required.

Asunto(s)

Glomeruloesclerosis Focal y Segmentaria , Inmunosupresores , Síndrome Nefrótico , Humanos , Síndrome Nefrótico/tratamiento farmacológico , Síndrome Nefrótico/patología , Síndrome Nefrótico/congénito , Masculino , Niño , Femenino , Preescolar , Estudios Retrospectivos , Siria/epidemiología , Inmunosupresores/uso terapéutico , Adolescente , Lactante , Glomeruloesclerosis Focal y Segmentaria/tratamiento farmacológico , Glomeruloesclerosis Focal y Segmentaria/patología , Resultado del Tratamiento , Inhibidores de la Calcineurina/uso terapéutico , Biopsia , Nefrosis Lipoidea/patología , Nefrosis Lipoidea/tratamiento farmacológico , Nefrosis Lipoidea/diagnóstico , Inducción de Remisión , Ciclosporina/uso terapéutico , Riñón/patología , Riñón/efectos de los fármacos , Rituximab/uso terapéutico

RESUMEN

OBJECTIVE: To analyze the overall frequency and inter-tooth patterns of caries in three populations from ancient cemeteries located along the western border of the Central Iranian Plateau as a means to explore whether the populations of Iran had greater access to fermentable sugars after the establishment of the great empires. MATERIALS: Dental collections from Kafarved-Varzaneh (Early Bronze Age, MNI=66), Estark-Joshaqan (Iron Age, MNI=57), Tappeh Poustchi (Timurid and Safavid Period, MNI=34), together with comparative data from NE Syria. METHODS: Frequencies of dental caries per tooth categories, location and size of carious lesions are analyzed using Smith's Mean Measure of Divergence, Correspondence Analysis, χ2 and Kruskal-Wallis tests. RESULTS: There are minimal differences in overall frequencies of carious lesions at Iranian sites, regardless of the chronology, but notable differences at Syrian sites. The inter-tooth pattern at the Iron Age cemetery in Estark appears distinctly different than the other Iranian sites and the comparative samples from Syria. CONCLUSIONS: Divergent subsistence strategies may be linked with different inter-tooth patterns since people buried at Estark were mobile herders, while the other cemeteries were used by settled farmers. SIGNIFICANCE: This comprehensive research on dental caries in three chronologically diverse populations in Iran sheds light on the association between dental caries and subsistence strategies, and introduces the Smith's Mean Measure of Divergence to explore inter-tooth carious patterns, which may prove useful to other researchers seeking to understand the relationships between subsistence, diet, and the presence of carious lesions. LIMITATIONS: The studied sample size is relatively small and therefore its temporal/regional distribution produces low-resolution results. SUGGESTIONS FOR FURTHER RESEARCH: More systematic research on the patterns of dental caries is necessary to produce more fine-grained reconstructions of diet and subsistence in Iran and around the globe.

Asunto(s)

Caries Dental , Humanos , Caries Dental/historia , Caries Dental/epidemiología , Caries Dental/patología , Irán/epidemiología , Historia Antigua , Siria/epidemiología , Paleodontología

RESUMEN

Polycystic Ovarian Syndrome (PCOS) is a prevalent metabolic and hormonal disorder affecting women of reproductive age. Limited data exists on Syrian women's PCOS awareness and health behaviors. This study aimed to gauge PCOS prevalence, knowledge, awareness, and health-related practices among Syrian women. A cross-sectional online survey was conducted from 11 February to 27 October 2022, targeting Syrian women aged 18-45. Collaborators from specific medical universities distributed a questionnaire adapted from a Malaysian paper through social media platforms. Out of 1840 surveyed Syrian women, 64.2% were aged 21-29, and 69.6% held bachelor's degrees. Those with a bachelor's degree exhibited the highest mean knowledge score (12.86), and women previously diagnosed with PCOS had a higher mean knowledge score (13.74) than those without. Approximately 27.4% were confirmed PCOS cases, and 38.9% had possible cases. Women with PCOS were 3.41 times more likely to possess knowledge about the condition. The findings suggest a moderate level of PCOS knowledge and health-related practices among Syrian women, emphasizing the need for increased awareness. Consistent local PCOS screening programs, in collaboration with obstetrics and gynecology professionals, are crucial for improving understanding and clinical symptom recognition of this condition among Syrian women.

Asunto(s)

Síndrome del Ovario Poliquístico , Femenino , Humanos , Síndrome del Ovario Poliquístico/diagnóstico , Síndrome del Ovario Poliquístico/epidemiología , Estudios Transversales , Siria/epidemiología , Prevalencia , Encuestas y Cuestionarios

RESUMEN

Childhood and adolescence, vital in shaping adult life and society, are profoundly impacted during conflicts like Syria's devastating war. This study explores the prevalence of behavioral disorders in Syrian children and adolescents, examining the influence of war and family-related factors. This cross-sectional study was conducted on children aged 2-17 years at a children's outpatient clinic in Damascus, Syria. We assessed parents' quality of life, war and family-related factors, and behavioral difficulties through parental interviews using two questionnaires: the Arabic version of the Strengths & Difficulties Questionnaire (SDQ) and the brief Arabic version of the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF). 74.67% of children aged 2-4 years and 61.29% of children aged 5-17 years were experiencing behavioral difficulties, with emotional difficulties being the most prevalent ones. Children exposed to kidnapping, family losses, lack of school enrollment, and those with parents having lower education, lower socioeconomic status, and poorer quality of life exhibited higher Total SDQ scores. The high prevalence of behavioral difficulties among children and adolescents in Syria is a major concern, with both direct and indirect war-related factors contributing to this issue.

Asunto(s)

Calidad de Vida , Humanos , Siria/epidemiología , Niño , Adolescente , Masculino , Femenino , Preescolar , Estudios Transversales , Encuestas y Cuestionarios , Padres/psicología , Prevalencia

RESUMEN

BACKGROUND: Vitamin D deficiency is an importance preventable problem in the global and associates with lack levels of awareness about vitamin D. According to prior studies, in the Arab world, there is low of knowledge and awareness toward vitamin D deficiency. The target of our study is evaluating the knowledge level about vitamin D deficiency and determining the associated factors with levels of awareness of its. METHOD: This online cross-sectional study was performed in Syria between 25 February to 29 March 2023 to assess the levels of knowledge about vitamin D deficiency among general Syrian population. The study's survey was obtained from previously published research and we conducted a pilot study to assure the validity and clarity questionnaire. All Syrian individuals aged 18 or older who were able to read and write and willing to participate were included, while, non-Syrian nationality individuals and all medical staff (doctors, nurses, and medical students…), as well, those under 18 age were excluded. The questionnaire consisted of 23 questions separated into four categories. The first section was sociodemographic information of the study population. The second section measured the level awareness of the study population regarding the benefits of vitamin D. In addition, the third and fourth part evaluated knowing of the respondents about sources of and toxicity consequences of vitamin D. The data were analyzed by utilizing multivariate logistic regression in IBM, SPSS V.28 version. RESULTS: Overall, 3172 of the study population accepted to participate in this research and 57.9% the majority of them were aged in the range among 18 and 28. While, the average age of the respondents were 30.80 ± 11.957. Regarding with the awareness toward knowledge of advantages and source of vitamin D and outcomes of vitamin D toxicity. Most of the participants mentioned that vitamin D is used to treat bone disease and rickets and contributes in maintaining calcium and phosphates (91.4% and 84.6%, respectively). Whereas, more than half of them reported that sun exposure does not cause vitamin D poisoning and that vegetarians are more likelihood to have vitamin D than non-vegetarians, (54.1% and 54.9%, respectively). Only, age and occupation out of nine predictors variables were significantly correlated with adequate knowledge of Vitamin D (p-value < 0.05). The respondents aged more than 60 years were high probability to have good recognition of Vitamin D than participants aged between 18 and 28 years. (OR = 7.95). Retired participants have shown lower aware of Vitamin D 0.38 times than students. CONCLUSION: Our research revealed that most of the participated individuals have sufficient comprehension about vitamin D, despite, there were significant gap. Health education via programs by government health-care agencies, NGOs and social workers is necessary to increase the awareness and knowledge toward benefits, source, deficiency and toxicity of vitamin D to avoid injury several diseases such as rickets.

Asunto(s)

Raquitismo , Estudiantes de Medicina , Deficiencia de Vitamina D , Humanos , Adolescente , Adulto Joven , Adulto , Estudios Transversales , Siria/epidemiología , Proyectos Piloto , Deficiencia de Vitamina D/epidemiología , Vitamina D , Raquitismo/complicaciones , Vitaminas